Fracture Care Challenges in the Austere and Humanitarian Environments

It is estimated that 80 % of severe fractures occur in the developing world. Long bone fractures of the femur and tibia treated conservatively with traction and casts require prolonged hospital stays and still often leave patients with significant lifelong disability. Locked intramedullary nailing is the standard of care in the developed world for management of these fractures. Humanitarian fracture care in an austere environment often means limited or no access to implants, a reliable power supply and intraoperative radiography traditionally required for locked intramedullary nailing. Creative surgeons with extensive experience in humanitarian work are making significant contributions to improve the management of these complex fractures in the austere environment through education of local surgeons and innovations in orthopedic implants and instrumentation.